Hepatic encephalopathy coexists with acquired chronic hepatocerebral degeneration

Brain MRI acquired at 3.0T. A) T1-weigthed images show bilateral and symmetric high-intensity of the globus pallidus, which reflects abnormal manganese deposition related to acquired hepatocerebral degeneration. B & C) Diffuse high-intensity in subcortical hemispheric white matter was observed on T2-weighted images. (D & E) The lesions were mildly hyperintense on DWI and unequivocal hyperintense on the ADC map likely reflecting interstitial edema secondary to hyperammonemia.